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Improving newborn survival rates in India

Professor Michelle Heys (UCL Great Ormond Street Institute of Child Health) used UCL-AIIMS Strategic Partner Funds to explore the delivery of digital clinical support for newborns in India.

Family members looking at the new born baby stock photo

5 June 2025

Most newborn deaths could be prevented if babies received the right healthcare in the right place at the right time. One and a half million babies currently die within their first month of life every year from preventable causes. Countries and regions with higher rates of deprivation also have higher rates of newborn mortality, meaning newborn survival rates are lower in the Global South.

In response to this, Professor Michelle Heys – a paediatrician as well as an academic researcher – developed and co-founded Neotree, a digital learning health system that delivers clinical decision support at the bedside. Having been implemented and evaluated in Malawi and Zimbabwe over the last five years, Michelle wanted to understand if a similar approach could work in India too. She successfully applied for the UCL-AIIMS Strategic Partner Funds to explore this question.

Pushing for equity in newborn outcomes

“At my core, I’m driven by equity,” Michelle said. “The equivalent of eight jumbo jets full of babies die every day from preventable causes. This is shocking inequity. And the issues are mainly around how strong health systems are.”

This is what led Michelle to develop and co-found Neotree, a digital system used by nurses and medical practitioners to help them make clinical decisions that will lead to the best outcomes. As a by-product of this, the system also collects data and delivers “low dose, high frequency” training – which all contributes to improving neonatal care over time. 

After being awarded the UCL-AIIMS Strategic Partner Funds, Michelle was introduced to Dr Sumit Malhotra, Dr Nushrat Khan, Nazneen Ali and Aditi Rao from AIIMS in New Delhi. Together, they researched questions relating to the need for an intervention such as Neotree in India, as well as the feasibility and acceptability to actually implement it. 

To understand the need, they explored the state of newborn care, the key issues around delivering quality care, and newborn mortality rates. To gain an understanding of the feasibility of implementation, they researched whether nurses on the ground thought a digital tool such as Neotree would be helpful for them. Information was gathered through a combination of quantitative data collection from existing records, and qualitative focus groups and interviews – focused on the Nuh district of Haryana.  

“Even before we’d introduced the concept of Neotree, the nurses in the qualitative work were saying that it would be great if they had a data collection system that enabled them to have clinical guidelines ready at the bedside,” Michelle explained. “We’re still analysing the results, but the preliminary findings show there is a need. India is huge, but this is particularly the case in areas of higher deprivation and therefore higher newborn mortality.”

Next steps towards making a difference

The collaborators now plan to apply for more funding so they can adapt Neotree for the India context, with the Indian Institutes of Technology (IITs) likely coming on board as a partner. “One of the key things in terms of sustainability and scalability is integration with existing and future digital and electronic medical records systems,” Michelle explained. “We're not trying to replace existing technology, and we're not trying to be a standalone tool. We're very much trying to work with what’s in place, and what's planned in the future.” 

Part of the process of adapting Neotree for the India setting is to look at the content and clinical guidelines, ensuring this is in-keeping with national and state guidelines. Any changes to functionality, data exports, and mapping alongside existing data systems also needs to be explored. 

Once the team has adapted Neotree, the next step will be to run a pilot within a medical setting in India. Understanding how it works in real life, what the data looks like, and what the feedback is will all help to refine the system, thus enabling the best outcomes for patients. 

Michelle said the UCL-AIIMS Strategic Partner Funds have been critical in the process of creating an appropriate solution to support newborn care in India. “Research is all about relationships, and you need to be able to build those relationships,” she said. “These seed grants are a great way of testing an idea and getting to know your collaborators. It means that when you get to the stage of submitting larger grants, you have a more equitable partnership. You have those relationships, you're building the proposal together, and you have that preliminary data and evidence to build a stronger case.”

The benefits – both professionally and personally – have made an impact on Michelle. Having previously visited AIIMS to develop a Master’s programme on digital health innovation, she was “acutely aware of them being a really well-known, very good potential collaborator. We’re trying to end preventable newborn mortality globally, and it's great to have the opportunity to work with really good people in different settings,” Michelle said.  “Apart from the science, that's what I really love.”

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